Although the deleterious effects of Childhood Sexual Abuse (CSA) are well-established, little previous research has examined factors that predict better or worse outcomes in the aftermath of abuse. This study identified factors that might explain the observed variability in the psychological consequences of CSA in women and to determine if coping style is affected by the severity of CSA and/or family environment and if differences in coping style affect female adult psychological functioning. CSA histories were obtained from a sample of 5,235 female Navy recruits. In this study we tested a model of the impact of abuse severity and family environment on the manner in which females cope with CSA. In this same model, we evaluated the influence of coping style on psychological adjustment Severity of abuse, parental support, and attachment style were significantly and independently associated with symptomatology and the strategies women reported having used to cope with the CSA experience. A mediational model, with coping style mediating the effects of abuse severity and family environment on symptoms, provided a good fit to the data; adding direct paths did not improve the fit of the model. Neither attachment CSA contributed to the mediational model. These data suggest that under some circumstances female victims of CSA may benefit from therapeutic approaches that emphasize expressive coping skills.